Helicopter emergency medical service (HEMS) activity after increased distance to out-of-hours services: an observational study from Norway
Abstract Background Organizational changes in out-of-hour (OOH) services may have unintended consequences for other prehospital services. Reports indicate an increased use of helicopter emergency medical services (HEMS) after changes in OOH services in Norway due to greater geographical distances fo...
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12873-020-00377-0 |
| _version_ | 1819169667987537920 |
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| author | Dag Ståle Nystøyl Jo Røislien Øyvind Østerås Steinar Hunskaar Hans Johan Breidablik Erik Zakariassen |
| author_facet | Dag Ståle Nystøyl Jo Røislien Øyvind Østerås Steinar Hunskaar Hans Johan Breidablik Erik Zakariassen |
| author_sort | Dag Ståle Nystøyl |
| collection | DOAJ |
| description | Abstract Background Organizational changes in out-of-hour (OOH) services may have unintended consequences for other prehospital services. Reports indicate an increased use of helicopter emergency medical services (HEMS) after changes in OOH services in Norway due to greater geographical distances for the on-call doctors. We investigated whether HEMS dispatches increased when nine municipalities in Sogn og Fjordane County merged into one large inter-municipal OOH district. Methods All primary dispatches of the HEMS in the county between 2004 and 2013 were included. We applied interrupted time series regression to monthly aggregated data to evaluate the impact of the organizational change 1 April 2009. The nine target municipalities were compared to the rest of the municipalities in the county, which served as a control group. A quasipoisson model adjusted for seasonality was found to be most applicable. Results We included 8,751 dispatches, 5,009 (57.2%) of which were completed with a patient encounter. Overall, we found no alteration in requests for HEMS after 2009 (p = 0.251). Separate analyses of the target municipalities and control group revealed no significant increase after 2009 (p = 0.400 and p = 0.056, respectively). When categorizing the municipalities into urban or rural, we found a general increase in HEMS dispatches for the rural group over the 10-year span (p = 0.045) but no added increase after 2009 (p = 0.502). The urban subgroup showed no change. Distance from the OOH service in regards to travel increased within the nine municipalities after 2009, median [quartiles] (5.0[3.0, 6.2] km vs 26.5[5.0, 62.2] km, p < 0.001). Conclusion After relocating nine local OOH services into one large inter-municipal OOH district, we found no increase in requests for HEMS. |
| first_indexed | 2024-12-22T19:23:09Z |
| format | Article |
| id | doaj.art-1ec986d69c9e43da8153dfb41b54d927 |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-12-22T19:23:09Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-1ec986d69c9e43da8153dfb41b54d9272022-12-21T18:15:19ZengBMCBMC Emergency Medicine1471-227X2020-11-012011810.1186/s12873-020-00377-0Helicopter emergency medical service (HEMS) activity after increased distance to out-of-hours services: an observational study from NorwayDag Ståle Nystøyl0Jo Røislien1Øyvind Østerås2Steinar Hunskaar3Hans Johan Breidablik4Erik Zakariassen5Department of Research, Norwegian Air Ambulance FoundationDepartment of Research, Norwegian Air Ambulance FoundationDepartment of Anaesthesia and Intensive Care, Haukeland University HospitalHealth Services Research Group, Department of Global Public Health and Primary Care, University of BergenCentre of Health Research, Førde Hospital TrustHealth Services Research Group, Department of Global Public Health and Primary Care, University of BergenAbstract Background Organizational changes in out-of-hour (OOH) services may have unintended consequences for other prehospital services. Reports indicate an increased use of helicopter emergency medical services (HEMS) after changes in OOH services in Norway due to greater geographical distances for the on-call doctors. We investigated whether HEMS dispatches increased when nine municipalities in Sogn og Fjordane County merged into one large inter-municipal OOH district. Methods All primary dispatches of the HEMS in the county between 2004 and 2013 were included. We applied interrupted time series regression to monthly aggregated data to evaluate the impact of the organizational change 1 April 2009. The nine target municipalities were compared to the rest of the municipalities in the county, which served as a control group. A quasipoisson model adjusted for seasonality was found to be most applicable. Results We included 8,751 dispatches, 5,009 (57.2%) of which were completed with a patient encounter. Overall, we found no alteration in requests for HEMS after 2009 (p = 0.251). Separate analyses of the target municipalities and control group revealed no significant increase after 2009 (p = 0.400 and p = 0.056, respectively). When categorizing the municipalities into urban or rural, we found a general increase in HEMS dispatches for the rural group over the 10-year span (p = 0.045) but no added increase after 2009 (p = 0.502). The urban subgroup showed no change. Distance from the OOH service in regards to travel increased within the nine municipalities after 2009, median [quartiles] (5.0[3.0, 6.2] km vs 26.5[5.0, 62.2] km, p < 0.001). Conclusion After relocating nine local OOH services into one large inter-municipal OOH district, we found no increase in requests for HEMS.http://link.springer.com/article/10.1186/s12873-020-00377-0Emergency medical servicesPrimary health careAir ambulancesNorwayHEMSGeneral practitioners |
| spellingShingle | Dag Ståle Nystøyl Jo Røislien Øyvind Østerås Steinar Hunskaar Hans Johan Breidablik Erik Zakariassen Helicopter emergency medical service (HEMS) activity after increased distance to out-of-hours services: an observational study from Norway BMC Emergency Medicine Emergency medical services Primary health care Air ambulances Norway HEMS General practitioners |
| title | Helicopter emergency medical service (HEMS) activity after increased distance to out-of-hours services: an observational study from Norway |
| title_full | Helicopter emergency medical service (HEMS) activity after increased distance to out-of-hours services: an observational study from Norway |
| title_fullStr | Helicopter emergency medical service (HEMS) activity after increased distance to out-of-hours services: an observational study from Norway |
| title_full_unstemmed | Helicopter emergency medical service (HEMS) activity after increased distance to out-of-hours services: an observational study from Norway |
| title_short | Helicopter emergency medical service (HEMS) activity after increased distance to out-of-hours services: an observational study from Norway |
| title_sort | helicopter emergency medical service hems activity after increased distance to out of hours services an observational study from norway |
| topic | Emergency medical services Primary health care Air ambulances Norway HEMS General practitioners |
| url | http://link.springer.com/article/10.1186/s12873-020-00377-0 |
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